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    • Welcome to Blue Cross Blue Shield of Massachusetts!
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Medical Plan Features

Blue Options

Tiered Network/Blue Options is a family of health plans that engages members with their health and coverage every time they get care through tiered benefits.

To improve the quality and affordability of health care, we will be implementing several enhancements to our standard plan designs. Learn about the plan changes designed to make health care more affordable.

With the plan, Massachusetts primary care provider (PCPs) and acute-care hospitals are placed into one of three benefits tiers based on how they scored on cost and nationally accepted quality benchmarks.

The tiered network drives value throughout the health plan because each time members seek care from a PCP or hospital, their cost sharing is based on the tier status of the provider they see.

This helps encourage members to consider the cost and quality of their PCP or hospital each time they get care and rewards them for choosing providers on the Enhanced or Standard Benefits Tiers.

Other benefits of the Blue Options family of plans:

  • Lower premium costs
  • The comprehensive coverage and easy to understand benefits of HMO Blue® and/or PPO Blue® plans
  • Access to office visits, prescriptions, emergency room visits, and mental health care for a copayment, similar to other HMO Blue and/or PPO Blue
 Compare Medical Plans

Have PPO Blue Options? Read the fact sheet.

Learn Blue Options in minutes.

Blue Options copayment only tutorial

Blue Options with deductible tutorial

How Tiers Work

Within Massachusetts, each time members seek care from a PCP or hospital, their cost sharing is based on which of the three tiers* the provider is assigned to. This helps encourage members to consider the cost and quality of their PCP or hospital each time they get care and rewards them for choosing providers in enhanced or standard benefits tiers.

  • Enhanced Benefits Tier—Includes Massachusetts hospitals and PCPs that meet the standards for quality and low cost relative to our benchmark.
  • Standard Benefits Tier—Includes Massachusetts hospitals and PCPs that meet the standards for quality and are moderate cost relative to our benchmark and hospitals that do not meet the standards for quality but are low or moderate cost relative to our benchmark. Also includes providers without sufficient data for measurement on one or both benchmarks. To ensure members have provider access in certain geographic areas, the Standard Benefits Tier includes some providers whose scores would otherwise put them in the Basic Benefits Tier.
  • Basic Benefits Tier—Includes Massachusetts hospitals that are high cost relative to our benchmark and PCPs that do not meet the standards for quality and/or are high cost relative to our benchmark.

* Note: PCPs were measured based on their HMO patients as part of their provider group, and hospitals were measured based on their individual facility performance. Provider groups can be composed of an individual provider, or a number of providers who practice together. Tier placement is based on cost and quality benchmarks where measurable data is available. Providers without sufficient data for cost and quality are placed in the Standard Benefits Tier. PCPs that do not meet benchmarks for one or both of the domains and hospitals that do not meet benchmarks for cost or that use nonstandard reimbursement are placed in the Basic Benefits Tier.

Provider Search

To see individual provider tiers, or how they've performed against our cost and quality benchmarks used for tiering just use our Find a Doctor tool.

You can also download a copy of a hospital tiering list to see how individual hospitals are tiered.

Additional Information and Resources

You have access to the tools and information that can make selling the Blue Options plans easy.

Blue Options Brochure — Introduces the value of the Blue Options plans to your clients.

Blue Options Fact Sheet — A quick overview explaining the benefits of Blue Options plans.

Tiered Services Cost Comparison Fact Sheet — See how the costs of services on different tiers stack up and how the Blue Options plans help drive members to high-value providers

Blue Options Educational Resources — Our Learn, Plan, Save approach helps members find lower-cost, high-quality hospitals, free standing labs and imaging centers.

Member Information and Resources

Your clients have access to a wide range of support tools to make educating and engaging their employees easy.

You can also access the tools by following the links below:

  • Member Education Web site — our specially designed web site (myplans.bluecrossma.com/medical-insurance/blue-options) makes it easy for new and current members to use their plan efficiently.
FAQ - Get answers to questions about:
The plan
Its benefits
How the deductible works

FAQ - Get answers to questions about:

The plan
Its benefits
How the deductible works

For more information on the Blue Options plans, contact your account executive or broker.

* National tiering is available to self-insured employers only.

This web site gives general information about our tiered network plan designs. There are currently three tiered provider networks called HMO Blue Options v.5, HMO Blue New England Options v.5, and Preferred Blue PPO Options v.5. In our tiered plans, members pay different levels of cost share (copayments, coinsurance, and/or deductibles) depending on the benefits tier of the provider furnishing the services. A provider's benefits tier may change. Overall changes to the benefits tiers of providers will happen no more than once each calendar year. For help in finding the benefits tier of a provider, visit the online provider search tool and search for the appropriate network.

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ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia con el idioma. Llame al número de Servicio al Cliente que figura en su tarjeta de identificación llamada 1-800-200-4255 (TTY: 711 ).

ATENÇÃO: Se fala português, são-lhe disponibilizados gratuitamente serviços de assistência de idiomas. Telefone para os Serviços aos Membros, através do número no seu cartão ID chamar  1-800-200-4255 (TTY: 711 ).

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注意:如果您讲中文,我们可向您免费提供语言协助服务。请拨打您 ID  卡上的号码联系会员服务部 通话 1-800-200-4255(TTY  号码:711 )。

ATANSYON: Si ou pale kreyòl ayisyen, sèvis asistans nan lang disponib pou ou gratis. Rele nimewo Sèvis Manm nan ki sou kat Idantitifkasyon w lan (Sèvis pou Malantandan Rele 1-800-200-4255 TTY: 711 ).

LƯU .: Nếu quý vị n.i Tiếng Việt, c.c dịch vụ hỗ trợ ng.n ngữ được cung cấp cho quý vị miễn ph.. Gọi cho Dịch vụ Hội vi.n theo số tr.n thẻ ID của quý vị Cuộc gọi 1-800-200-4255 (TTY: 711 ).

ВНИМАНИЕ: если Вы говорите по-русски, Вы можете воспользоваться бесплатными услугами переводчика. Позвоните в отдел обслуживания клиентов по номеру, указанному в Вашей идентификационной карте вызов  1-800-200-4255 (телетайп: 711 ).

ការជូនដំណឹង៖ ប្រសិនប. ើអ្នកនិយាយភាសា ខ្មែរ សេ  វាជំនួយភាសាឥតគិតថ្លៃ គឺអាចរកបានសម្  រាប ់អ្នក។ សូមទូរស័ព្ទទ ៅផ ្នែ កសេ  វាសមា  ជិកតាមល េខន  ៅល.  ើប ័ណ្ណ សម្  គាល ់ខ្លួ ខ្លួ នរប ស់អ្នក ហៅ  1-800-200-4255 (TTY: 711) ។

ATTENZIONE: se parlate italiano, sono disponibili per voi servizi gratuiti di assistenza linguistica. Chiamate il Servizio per i membri al numero riportato sulla vostra scheda identificativa chiamata  1-800-200-4255 (TTY: 711 ).

참고 : 한국어를 사용하는 경우 언어 지원 서비스를 무료로 사용할 수 있습니다. 신분증에있는 전화 번호 1-800-200-4255 (TTY : 711)로 회원 서비스에 연락하십시오.

ΠΡΟΣΟΧΗ: Εάν μιλάτε Ελληνικά, διατίθενται για σας υπηρεσίες γλωσσικής βοήθειας, δωρεάν. Καλέστε την Υπηρεσία Εξυπηρέτησης Μελών στον αριθμό της κάρτας μέλους σας (ID Card) κλήση 1-800-200-4255 (TTY: 711 ).

UWAGA: Osoby posługujące się językiem polskim mogą bezpłatnie skorzystać z pomocy językowej. Należy zadzwonić do Działu obsługi ubezpieczonych pod numer podany na identyfikatorze zadzwoń 1-800-200-4255 (TTY: 711 ).

ध्यान दें: य दि  आप ह िन् दी बोलते ह ैं, तो भा षा  सहाय  ता  सेवा एँ, आप के लि ए नि :शुल्क  उपलब्ध ह ैं। सदस्य  सेवा ओं को आपके आई.डी. कार  ्ड पर दि ए गए नंबर पर कॉल करें  कॉल 1-800-200-4255 ( टी .टी .वा ई.: 711).

ધ્યાન આપો:  જો તમે ગુજરા તી બોલતા  હો, તો તમને ભા ષા કીય  સહાય  તા  સેવા ઓ વિ ના  મૂલ્યે  ઉપલબ્ધ છે. તમા રા  આઈડી કાર  ્ડ પર આપેલા  નંબર પર Member Service  ને કૉલ કરો કૉલ કરો 1-800-200-4255 (TTY: 711).

PAUNAWA: Kung nagsasalita ka ng wikang Tagalog, mayroon kang magagamit na mga libreng serbisyo para sa tulong sa wika. Tawagan ang Mga Serbisyo sa Miyembro sa numerong nasa iyong ID Card tumawag 1-800-200-4255 (TTY: 711 ).

お知らせ:日本語をお話しになる方は無料の言語アシスタンスサービスをご利用いただけます。ID カードに記載の電話番号を使用してメンバーサービスまでお電話ください 呼び出す 1-800-200-4255(TTY: 711 )。

ACHTUNG: Wenn Sie Deutsche sprechen, steht Ihnen kostenlos fremdsprachliche Unterstützung zur Verfügung. Rufen Sie den Mitgliederdienst unter der Nummer auf Ihrer ID-Karte an Anrufen 1-800-200-4255 (TTY: 711 ).

ATTENTION: If you speak a language other than English, language assistance services are available to you free of charge. Call 1-800-200-4255 (TTY: 711).

ຂໍ້ຄວນໃສ່ໃຈ: ຖ້າເຈົ້າເວົ້າພາສາລາວໄດ້, ມີການບໍລິການຊ່ວຍເຫຼືອດ້ານພາສາໃຫ້ທ່ານໂດຍບໍ່ເສຍຄ່າ. ໂທ ຫາ ຝ່າຍບໍລິການສະ ມາ ຊິກທີ່ໝາຍເລກໂທລະສັບຢູ່ໃນບັດຂອງທ່ານ ໂທ 1-800-200-4255 (TTY: 711).

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